Thoracic sarcopenia predicts clinical outcomes in patients undergoing coronary artery bypass grafting: A 6-year cohort study

Shen, Zi-Le; Liu, Zhang; Zang, Wangfu; Zhang, Peng; Zou, Huawei; Dong, Wen-Xi; Chen, Wen‐Hao; Yan, Xialin; Yu, Zhen

doi:10.1016/j.asjsur.2022.03.096

Cited by 8 publications

(18 citation statements)

References 36 publications

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“…Measurement of body composition and its impact on outcomes after cardiac surgery are gaining increasing attention. Our study has previously confirmed that preoperative sarcopenia is associated with unfavorable short-and longterm prognosis of patients receiving CABG (10). Estimating preoperative skeletal muscle index (SMI) has a predictive effect and allows for timely therapeutic intervention for better postoperative outcomes.…”

Section: Introductionsupporting

confidence: 71%

“…The skeletal muscle area was normalized by height (m 2 ) to determine the SMI (cm 2 /m 2 ) at T12. Consistent with our previous study, referring to a large-scale study, low SMI was defined as T12 SMI < 28.8 cm 2 /m 2 for male and < 20.8 cm 2 /m 2 for female (10,17). T12 SMI per cent change (%T12 SMI-change) was calculated as (postoperative T12 SMIpreoperative T12 SMI)/preoperative T12 SMI × 100%.…”

Section: Quantification Of Skeletal Muscle Massmentioning

confidence: 60%

“…Recently, preoperative sarcopenia has become a prognostic indicator for various types of surgery (31)(32)(33)(34), whereas few studies investigated the impact of preoperative skeletal muscle loss on survival in patients receiving CABG. In our previous study, preoperative sarcopenia was proved to be an independent risk factor for postoperative complications and OS of CABG (10). Actually, postoperative skeletal muscle loss not only leads to a decrease in postoperative quality of life (18), but also causes decreased exercise capacity and impaired respiratory function (35).…”

Section: Discussionmentioning

confidence: 99%

“…Considering the dynamic change of SMI during perioperative period, it may inadequate to merely assess the state of skeletal muscle before surgery to predict the clinical outcomes of the patients and formulate postoperative rehabilitation programs. Nevertheless, the few existing studies mainly focused on the impact of preoperative skeletal muscle assessment on the prognosis of CABG patients (10,15), and the relationship between postoperative skeletal muscle loss and clinical outcomes in these patients is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic significance of postoperative loss of skeletal muscle mass in patients underwent coronary artery bypass grafting

et al. 2022

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BackgroundIncreasing life expectancy of coronary artery bypass grafting (CABG) remains to be the major concern of cardiac surgeons. However, few studies have investigated the effect of postoperative skeletal muscle index (SMI) loss on prognosis. This study aims to evaluate the prognostic role of postoperative SMI loss ≥ 5% after CABG, in order to develop a novel nomogram to predict overall survival (OS).MethodsPatients underwent CABG via midline sternotomy from December 2015 to March 2021 were recruited in this study. Preoperative and postoperative 3 months chest computed tomography (CT) images were compared to assess changes in SMI at T12 level. Based on this, patients were classified into the presence or absence of SMI loss ≥ 5%. The association between postoperative SMI loss ≥ 5% and OS was then analyzed by the Kaplan-Meier curves and Cox model. A novel nomogram incorporating independent clinical prognostic variables was also developed.ResultsThe study enrolled 506 patients receiving CABG, of whom 98 patients experienced T12 SMI loss ≥ 5% and had a significantly worse OS (P < 0.0001). Multivariate regression analysis showed that T12 SMI per cent change (%T12 SMI-change) was an independent prognostic factor for OS (HR = 0.809, 95% CI = 0.749–0.874). The nomogram incorporating %T12 SMI-change with other variables was accurate for predicting OS. Besides, we also found that postoperative oral nutritional supplement (ONS) can rescue T12 SMI loss.ConclusionPostoperative SMI loss can predict survival outcome after CABG. The nomogram incorporating changes in SMI provides a superior performance than existing systems.

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Section: Introductionsupporting

confidence: 71%

Section: Quantification Of Skeletal Muscle Massmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic significance of postoperative loss of skeletal muscle mass in patients underwent coronary artery bypass grafting

et al. 2022

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“…The total skeletal muscles at T12 level contained the rectus abdominis, external oblique, internal oblique, latissimus dorsi, intercostal, and erector spinae muscles. Consistent with our previous study, cutoff values of T12 SMI were referenced from a large-scale study, which were 28.8 cm 2 /m 2 for male and 20.8 cm 2 /m 2 for female, respectively [13,14].…”

Section: Muscle Mass Measurementsmentioning

confidence: 56%

Development and Validation of Global Leadership Initiative on Malnutrition for Prognostic Prediction in Patients Who Underwent Cardiac Surgery

et al. 2022

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The Global Leadership Initiative on Malnutrition (GLIM) has achieved a consensus for the diagnosis of malnutrition in recent years. This study aims to determine the prognostic effect of the GLIM after cardiac surgery. A total of 603 patients in the training cohort and 258 patients in the validation cohort were enrolled in this study. Perioperative characteristics and follow-up data were collected. A nomogram based on independent prognostic predictors was developed for survival prediction. In total, 114 (18.9%) and 48 (18.6%) patients were defined as being malnourished according to the GLIM criteria in the two cohorts, respectively. Multivariate regression analysis showed that GLIM-defined malnutrition was an independent risk factor of total complication (OR 1.661, 95% CI: 1.063–2.594) and overall survival (HR 2.339, 95% CI: 1.504–3.637). The c-index was 0.72 (95% CI: 0.66–0.79) and AUC were 0.800, 0.798, and 0.780 for 1-, 2-, and 3-year survival prediction, respectively. The calibration curves of the nomogram fit well. In conclusion, GLIM criteria can efficiently identify malnutrition and has a prognostic effect on clinical outcomes after cardiac surgery. GLIM-based nomogram has favorable performance in survival prediction.

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A novel insight into the key gene signature associated with the immune landscape in the progression of sarcopenia

Shen,

Chen,

Liu

et al. 2023

Experimental Gerontology

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Thoracic sarcopenia predicts clinical outcomes in patients undergoing coronary artery bypass grafting: A 6-year cohort study

Cited by 8 publications

References 36 publications

Prognostic significance of postoperative loss of skeletal muscle mass in patients underwent coronary artery bypass grafting

Prognostic significance of postoperative loss of skeletal muscle mass in patients underwent coronary artery bypass grafting

Development and Validation of Global Leadership Initiative on Malnutrition for Prognostic Prediction in Patients Who Underwent Cardiac Surgery

A novel insight into the key gene signature associated with the immune landscape in the progression of sarcopenia

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